RT Journal Article
SR Electronic
T1 Rescue Therapy With a Pumpless Extracorporeal Lung Assist Device in a Patient With Acute Interstitial Lung Disease and Severe Refractory Hypercapnia
JF Respiratory Care
FD American Association for Respiratory Care
SP 293
OP 297
DO 10.4187/respcare.01290
VO 57
IS 2
A1 Martin Petzoldt
A1 Stephan Braune
A1 Iris Bittmann
A1 Stefan Kluge
YR 2012
UL http://rc.rcjournal.com/content/57/2/293.abstract
AB Idiopathic interstitial pneumonia frequently causes severe pulmonary restriction that in turn makes mechanical ventilation difficult. We report the case of a 44-year-old woman who developed a refractory severe hypercapnic respiratory failure (PaCO2 281 mm Hg, pH 6.77) despite mechanical ventilation with high inspiratory pressure and PEEP. A pumpless extracorporeal lung assist device, Novalung, was used as rescue therapy for carbon dioxide removal, enabling lung-protective ventilation and normalization of life-threatening acidosis. Open lung biopsy revealed an idiopathic interstitial pneumonia with histological features of a nonspecific interstitial pneumonia. Corticosteroid therapy led to progressive improvement of pulmonary function, soon permitting cessation of mechanical ventilation and extracorporeal therapy. The patient was discharged from the intensive care unit after 20 days. This case demonstrates the successful use of pumpless extracorporeal lung assist as an alternative device to pump-driven extracorporeal membrane oxygenation in severe hypercapnic respiratory failure secondary to nonspecific interstitial pneumonia.